HomeMy WebLinkAboutBuilding Permit 99-0217
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/J..J() 19
ADDRESS
l/.5t1b /~4JI^
OWNER
CONTR.
PHONE NO.
PERMIT NO.
\~"~\1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION~
FINAL
~ SITE INSPEC ON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~~..R P
~ GO,
.,(~ ~
v
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOrl
Job Address
Heating Contractor
Name of Tester
Date
Percent O2
Percent CO
Percent C02
Stack Temp.
~~
b1/C:
.~
'1-9- f'7
7J;
o
~~
/220
Combustion air is adequately supplied per
UMC Sec. 606
Input
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
?~)191 /.' 3eJ
L/!5z(o #VHMINGt3IP/)
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Cfc;- 2/7
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION e 0 SEWER HOOKUP 0 FIREPLACE FINAL
~FINAL "Ct-0Gj . r ~ PLUMBING FI~ tf\) 0 GAS LINE AIR TST
o SITE INSPECilo ~ MECH FINAL & ~ 0
COMM~~TS: ,~ ~d:::.Lk~ ~~
UJ-1-J~ ~-H-.
~, f7ve:; 0 '$(~ CJFf=
> DbN 0- ~ f2-.5 CA-/VA0- ~~//VCc:>
o v.syL ~~,f'1~ /) _ ~
1- '2- S~ //\J j?t-r--(c:V ~K
T. r""_,;r;J.
-'-0
} I
/1 /1 fctC1
o . I I
o WORK SATISFAC10RY, pROCEED
)( CORRECT ACTIOt; AND PROCEED
o CORREC; rr. CALL FOR ~EINSPECTlON BEFORE COVERING
Inspector: Y l Owner/Contr:
CALL 447-~850~THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
7- '1--'10/
1(: ?o
ADDRESS 4;2<0 ~W llz...
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c,q - 'U7
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
~MECHANICAL
ATER HOOKUP
SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
kCO~~S,/~~",~ ~iC \ '2 '
. 3- ~ ~ Lut-I'"~
IV\ Lu'
r-
ty~
~Gy<-fc
A
(Jr~ ~
~ tY/,A/' ~
(~)l_ +~ ~
I
JQo~
h~
/
/
/
o ~RK SATIS~FTOR PROCEED
~ECT AC ION AN I ROCEED
o CORRECT WORTl '- OR EINSPECTION BEFORE COVERING
Inspector: \ _ Owner/Contr:
--
CALL 44 230 FC R THE NEXT INSPECTION 24 HOURS IN ADVANCE..
'NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'-'~'r~'~'"" ._,...._-.-'""'--....._'~'1~~~..~~.~.'~:- ~~-.~...~<.or~ '.~~~~, ~,~,_1.~ -~~~~ .:r~.~.~~'l. -'~'~""W~;
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(fTc, t Contractor's N",... ,. ,', ....p..MCNEARNEY CUSTOM HOMES PO BOX 366, LAKEVILLE MN. 1L~'\
ROBERT D. HUTCHINS ~ Ci Planner
ell ~~ ~ ~
)~~_. 1tJ.-JQ~~9 Date: .~
\ ',V . Date. \'
(~ TrT ~r~~,T ~N .~.C~~~~:~~~S:~A_CE __ ~~.~~ _'.__ .JP~
(-, ""'... . '"''"'" ..~~.,. ~,+ :~.,,'-~""'_. ~_..~.,~ '.~"",+~"'" ... '"'" :~... .~JJ;;:~ ,.~.... ...... ~~
/l.. ~ . - . t .~. ~ ..~. -:F~ ~.. .~. .~.~.. .. t ~ t ~ . '1Eii~. t .~~.~...t.~ ..,~. 'iii' . ~~. ..:'i!.>. . ...'AI:"
~".""""jOl~ . lC' '~.,.. ";.( .. l'oI 1oI~'~;( ~,~~..
~ - --- - - - - - - - - "'-- - - - - - - - - - - - - ~ - - --- '- ~"'='" -
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....."~.-"._ _,..". .H......"'"
1
QLtrtifirau of ~rrupantY
CITY OF PRIOR LA}(F.
Jaepartmtnt of ~uilbing Jn~ptttion
)(Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursufmt to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior Lake regulating building construction or use. For the following:
Use Classificatiol'
SINGLE FAMILY
Bldg. Permit No.
99-217
Occupancy Type
R3
Fire Zone
N/A
VN
Zoning District R 1
Type Construction
Legal Description ,U 1 _ R~ KNOR HTT.T.S ~lm AnnT'rTON
Owner of Building
lOli"~Address 4526 HUMMINGBIRD TRAIL
SCHEDULED
DATE
Lf/(). 7
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
3:00
OWNER
LfS-d~ Humtn'f\OJbircl
CONTR. (J
ADDRESS
PHONE NO.
PERMIT NO.
qq - ;/(7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
';;g(FINAL 'BLd..~.
I/" 0 SITE INSPECTloN
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
.
fA 8 I /}J7J"'3 ~ Il- 30 .-?cy
~ (J(}-U- ~ ~ (~ ~ 'tI--
~.O..V ~ ~ o..J-~ ~ o-r^^-
~I ~-. LJ-
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Ik,
/1 .
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
MAR 2 5 199c) TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.gq_~ Z~7
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
3-dS-qQ
~I
PID ;?':> -3l(1- ()71G1:l
IJ dd,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(HeightJ.. I (Width)
;;..7 7 '"
12, NO. OF STORIES
~
2. SITE ADDRESS
4i)-z..G U HIL-LI'W {\(',\)' blYCl lL
3. LEGAL DESCRIPTION ,
J I BLOCK.3
k JJ 0 b H I II 3 1..d
(D~h~ /
LOT
13, TYPE OF CONSTRUCTION
5, h p~
(Tel. No.) , 14, FLOOR AREA APPORTIONMENT USE
L4Jfr.c.///c.. (~~/J""J-J'I~S- :J-,s-J- 7 /If
- I
(Tel. No.)
tfhf-)./I (,
(Tel. No.)
(~S/) y(P;J- 3 V ~r
ADDITION
4. OWNER (Name) (Address)
110 h ~ IZ"I }.--/c AI-< A I'<. N ~f I? (), 80 ~ ~ ~ ~
5, ARCHITECT (Name) '(Address)
ftllJ Il j( ;<. Yak'm'e~)
6, BUILDER ~c
Ifc .6 ~ ~ r me A.J t' 19 ~ AJ of! i
CtlS TOM J/o;'YI"j
(Address)
fJ. o. 8 oX 3 ~ ~
l..Aj(<..v'- II<c/ J1'1Aj,
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
7. TYPE OF WORK /' Fireplace 0 Septic 0 Deck 0
New Construction 0/' Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10, CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. I}: 0 I q Width '1/) I Depth /3J- f Yes @ 11...5: /I, ~
I hereby c6rtify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
:Uild~~VOm perm' or just cause. Furthermore, I hereby agree that the city Officia~r i ~Vee may enter upon the property to perf3 bed:; Isqc7ns.
- - Signature License No. Date
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
"'._J' _,' _II' _.
._ l,_ ".__
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
~~t'\
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
USE OF BUILDING
I SCJ .CJ::C> . (!)e:,
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Amount Brought Forward .................. $
Park Support Fee ........................... $ 8<:7"') .c:Q.
SAC ......................................... $--LrJ~J .~a
Collective Street Fee ....................... $
Sewer Tap ................................... $
City:
,.-
I. I <;;,') 'LS
l~.41
71 . c;-o
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
j!
\ ~ (}vl\.
~2t
$
Pressure Reducer .....'-................. $
Meter Hom ..... q........................... $
Water Meter ...18>.......................... $
Sewer & Water Connection Fee ........... $~CJO . () ('\
Water Tower Fee ........................... $ 7 t'l C') .()G
<Ie; .00
(00.00
lOO -co
bS . 50
lio , cc)
/2<;:00
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $ I, e.,-O CJ ,00
Other ......................................... $
Total Due .............................. $'7775. 7;Z
Paid 7"71 'S"' ~ , '- Receipt}-J,o. 35" II I
Date 4/30/QQ By 1:1Q
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning drdin~c; arid may proceed a; requested, This document when
sig~Pla r constnutes a temporary Certi~~eW~~~~rPliance and allows construction to commence, Before occupancy, a Certfficate of Occupancy must be issued.
'" C Date . Special Conditions ~ any
Thisrli~tii BecolJ1es Your Building Permit When Approved,
By ~ (/.~ Date ?-'?1'l-9 c:;
.,;-.....'- . 1I \""...0--" ./ .....~ (
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
. . - APR. 9.1999- 7: 03AM
GENZ-RYAN
NO. 194
P.1/2
I. i1ull F1Ic
%. Gald ClI'Y
3. Yell" ^"U=t
q q - 2 17,
CITY OF PRIOR LAKE
PLUMBING PERMIT #
ApplIcant; bl!112-12~11 nPhone: 4~~-11L/4
Address: '\..I.llf c:; . 1<./'1 hoP r+ Tr I
Signature: &"i". b4~~
Legal Description: Lot _ Block-----.-- Sub ~b I4W ~rol '
Site Address: 45:z..-'~ }.J-LAJ"ntn'l nab i rri I r'
Building Permit # q q - Z I 7 <J ,PID 4t ?5' 3L{-q - O:lJp ~ 0
NOTE~ This permit 'It!ill not be precessed without complete information.
FIXTURE UNITS
Quantity Type of Fixture QuantitY Type of Fixture
~ 8ath Tub with or without shower '3 Rough-ins
'I Dishwasher I Water Heater
J Floor Drain ~I Water Softner
-
4- Lavatory (bathrQom sink) J stand Pipe (washing machine)
I Laundry Tray (1 or 2 compartment sink) Sewage Ejector
I Shower Stall 8atkftow ASSembly (FlPZ. Dauble Check, PVB)
J Sinks 8aclcflow Assembly Test
ear Sink L.awn Sprinkler
I .. .~ Water Closet (toilet) Other
FEE SCHEDULE .
Industrial. Commercial & Multi-Family
(1 ~o of job cast. $39.50 minimum)
Residential, New One & Two Family
Residenrial. Additions & Alterations
State Surcharge
$99,50
539.50
5 .
$ $_=0
$
$
.50
GRAND TOTAL
$lCO.OO
This penniE is granted upon the e&prcn ~Dnclllion that said
contruc:Ulr. shDll comply in Dll respects with the ordinnnces
of the Swc Plumbin!: Code aneS the amendmcl'ts thereof.
~ ~I}~ NO. i!r1t-u4 ~ DATE
./~~ ,', .AII~I
Call for wI ~nspections 24 hours in lldvl1l1ce.
PAIL> WITH
BUILDING PERMIT
16200 E:lgle Creek: Av. S.E.. ~~r Lap.. Mi.nn~sot:l553721 Ph. (~12) 4474230 I FA.,"( (612) 447-42~5
. AI! Equ:11 OPtlonuni~ Employer
. ,.-
crt} Z , I
White - Building
Canary - Engineering
Pink - Planning
TIw CftI'or ., .110 lAke C...lry
APPLICATION RECEIVED
~il [t\Je(H I lEt t
---J ., - fJ( l.{'
.-<} (')
,
It'fl LtS
NAME OF APPLICANT
The Building. Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.1/';2& +1 ili ) I ill/I LjiJl/;' 11<.
'.
Accepted
./
Accepted With Corrections -
Denied
Reviewed By: lJAL-rJ:'R f:~'~,!,""4UJtoJ
Date: 313oJ~
. .
Comments: ~oFF M-a-r ~ CO^JIIEt/~J> 1"b ANO A'-oN.'.- DI1RWAGr &ll' .Jnu.IX-
rA<~MF..,.rrr.. As ItfIJGH JII<: ~,.,c"'(.. -
Uu-
CAU'T'I...I l.h4lEN C.OI\J~T'4.Uc.rlQlJ
AcrnJ.-N Oc.c....R-S ""E~/1.. .....HE. (!.ATe" J3A.S1t-J dN -r}.Il!: "'EllA.. UK CtJR.AJl!1l. AS
""0 No"T' 1:) AMAC'. E ,-,.
SIE.E. Wf'ol't#lA-"-,O^' 0,.1 RE\lLftSE. ~ I O~.
'F". ""'" L. r: ItA~
M.\IS"i' U F"L"'S'"
&.J,nt ~Arc'" BASIN DN RCIM. L4"-
.co'l1'J~4 -
5!E. A"T'rACJ.lM(.u1'~: J. h"...,AL (JR..4j)I~" I.NSPEc~A.Jro(lM,q-rlJ2.N ~"'lI'A1& t:tA~
3. ttttl.s",A) CCWT40\- M E.,.~Q..E"S
tl.-ttlOS'Or-J (l,dlAl1'"a 01.- ?~...u
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid.-
. " i '~/
if r ( t /
White - Building
Canary - Engineering
Pink - Planning
Th~ Cf'nln of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,
i;
j U {
I o'{
, I
i.
ii, ! ) I
/
i( i! i ( _j
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"
"
I ,'.:
Accepted
V'
Accepted With Corrections
Denied
Reviewed By:
Comments:
<-J> ~
~ -
~ Date:
3 ..-2-~~?)~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
C(Ct-z-/7
Tho Conlo' of lho Loko Counlry
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHI;.CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
H cJJffif[ Vlf-tj
j
?r2S'-qQ
fus +awt
f-h/U6
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4520 tf.uvVlrVltt ibird IIZ.
Accepted
Accepted With Corrections x:
Denied
Reviewed By: /4J~.;;;(
Comments:
Date:
5'- '10--'71
(. ~o~ ~aR -f-..r-e~ f& dJCLU<L~ ?~_
2. 'P\c...:.:t:~. A ~'51~ ~
? ~~tL~ ~~
-::>
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~ . CITY OF PRIOR LAKE
~ 16200 E"lI11 CreekAv. S.E. P.,mll No. GIGI - 217
~ Prior Lak., MN 55312-
HEATING APPLICATION' PERMIT
Dale, LWq/qq PIDI,2.5-344.0ZiD'O
Sile Addrell Llt7~~ ~~ ~ct. ~j
Lol J} B~. fI3 Addinon, Kn 0 b (J I-H I I ~ ("~
OWner"8Nllme. W.e.n.~rn OJ"\. " J-/ej Yn O~
Mlfr.1S J'Rqf=, ~/().LLa" ~
Heating ~n\fac&or, ~ ~ a.t\.."
Addr.ss. \414~ c.... .~b~+ T. I
Telep"one' , W. ~3- J JLJ.y.
FurnllCll Milke & Mooel h.L.J"\.t'V')~
Mad.1 Slz8 ~~l.o Ge! 4 - 100
Com. Load
Fuel tJAl ,~!l~ Flu. Slle 5 I'
SURlI, Openings, ~ \
10
Retum Openings .
lnput Jnf.lt""rV) Output q 1\ noO
. ~
Ed;'.
CJm-,
TYPE OF SYSTEM
Warm Atr Planw. ~
Grav!Iy,
MechanIcal ,
Air Condllbnlng ,
Vent System.
HEATING OR POWER PLANT
Steam ,
Hol Wider .
Radlatla,. ,
Speclal Devices
Otha, DavleBs .
TYPE OF WORK
tfBw ConstructIon
~
AIIer.lIona
Repair.
Ed. Cold . .
HEATING PERMIT FEE $
STAlE SURCHARGE $
TOTAl'PERMlr FEES $
:TVPE OF STRUCTURE
1. ]'ilii
1. Ore
,. Yell..
Rle
City
en..lrKlGl
Single FamUy
Commercial
............... ,Two-family
'ndus'rlal
Fee Sdtedula
Industrlal, Commercl!ll & MuUi.Famlly
Residential, Heating.'& AC
ResIdential. Heatlr\g Only
Reslden1Ia'. Gas Fireplace
ResldenUal, Adrtillons . AUeratTons
Residential, AC Only
Mulli-Famllv c
Public Other
D
-0
;;0
N
W
~
U)
U)
U)
1 % of lob cost (139.60 minimum)
$99,50
$64.50
SS9.50
$39.60
'39.50
-'I
~
N
D
3:
G)
fT1
Z
N
I
;;0
-<
D
Z
Remember 10 add the Stale Surcharge on 'he bollom ollhls applicaUon.
The.prlce 01 your healk1g permit Includes one rough-In Bnd one flnallnspecllon.
Additlona' tnspecllons wil be billed at $9.5.00 each.
House Heating Tes' Atlcord musl be submItted wllh building 1"'~""'Jt 'mrnh"'''' before build.
Ing certl1lca'e of occupancy wlU be Issued.
.....J:6T r.., r" II .Tln"r~ ~I=n' IIRJ:Jl wllh number of euppty Bnd .etum op.nlngs listed per
room Wl1h CFM's per opening. New slructur.. or 8ddiUons lend 1100' plan with supply
Bnd return locations shown. HEAT LOSS CAlCUumONS, PAYMENT AND
APPLICATIONS MAV BE MAilED TO THE CITY OF PRIOR LAKE. 16200 FJ.GlE
CREEK AVE. S.E. PRIOR LAKE, UN 55372.
City Hall business tlours are 8 8.m. - 4;30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALl. CITY HALL
-441-4230
I hereby apply for a mechanical systems permit and lac1cnowledge Ihal the
inlolmallon above Is complele and accuralB; 'hal the work will bBln conformance
with Ihe ordinances and codes of the cll~ and with the atale bulldlng/mach.nlc.' 6
code.: that this form does nol become 8 permll unlll algned by the BUILDiNG .
OFFICIAL~ Ihat the work will be tn accordance with lhe approved plan In the . ~
case 01 all Walk which requIres review and approval of plans. ~
Building Ofllcal's Sli;netU1B
li/q/tf/
Dale
4/z."3/QQ
Dille
-0
N
"'-
N
AepSacemttnt
Esl. Camp. Date .
Dunding P.,mil' ,
qq. GO PAID WITH
.50 ' I BUILDING PERMIT
I ()() .00 ReceIpt".
CrTY OF PRIOR LAKE /V) 1
16200 E.gle Creek Av. S.E. Pem\i1 No. Vf1 - d. / _
Prior Lab. MN 55372
Da1e
PID, c2j- 3qcj- ()a~ -()
tat
Owrter's Name
Address .
HB~ng Corh:fDr A 0. ~ L' AJ f1 u ~
4ffJ(p fv.fl,d~L Sf-
Telephone' . ~~,,_ ~ ),~() 0
Furnace Mabl Model +-I- NG
1/1 (J7fl)
fL,
'-lIt/- t./~ l/ ~
Address
or
Model Size
TYPE OF SY'STEM
Warm All Plarcs
Grallily
Mecharical
Ail Conditioning
Vent. Syfiem
HEAlWG OR POWER PLANT
Steam
Hot Waist
Radildion
Special DIvas
Com.~
Fuel ,JJ-. 'f:P-F~. Size
Supply Openirgs
Retum Openirvs
IIlfMI' 1... g m ,Output
'61lJ. 5
Edr.
OthBr Devices
Cfm.
TYPE OF WORK
)(
Al8ndions
Replace'nent N_ Construction
RepU
Est CosI S
Est Camp. Dale ,
I S-1fD"-- Buildi\g Permit' _ qq - ~/7
~'"
JUILDING PERMIT
HEATING PERMIT FEE I
STAlE SURCHMGE $
.50
TOTAL PERUIT FEES S
Receipt. -
I.l'li*
Z GnED
J_ YdIaw
File
City
I....." . I,~ :..,
TYPE OF STRUcnJRE
Sl1gle Family
Commercial
)(
. Two-Fam.V
M~-FamUy
Other
Industrial
Public
Fee SchecUe
Industrial, Commercial & Mu1ti-Famity
Residential, Heating & AI;
Residential, Heeling Only
Residential. Gas Fireplace
Residential. Addilions & Alterations
Residential, N; Only
1% of job cos1 ($39_50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remermer to add the Stale Surcharge on Ihe bottom of this applicatioo.
The price 01 your heall1g peRril includes one rough-in and one final inspection-
Additional inspections win be billed all35..00 each.
House Heati'lg Test Record mus1 be submitted with huildina nermil number before build-
ing oerlificale of oa:upancy will be issued.
HEAT r.AI CUI ATION~ REOUIRED with nlmber of supply and relUrn openings listed per
room with CFM's per opering. New stlUClUres or additions send Door plan wilh" "" 'y
and return locations shown. HEM lOSS CALCUlATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR \.AJ<E, 16200 EAGLE
CREEl( AVE. &.E. PRIOR LAKE. UN 55372.
C~ Hall busi\ess hours are 8 a_m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGtWN AND RNAL) - CALL CITY HAll.
447-4230
I hereby apply for a mechanical systems permit and I acknowtedge that the
information above is complete 9I\d accurate; that ft\e work will be in comormance
with the ordinances and codes of the city and with the state building/mechanica'
codes; that this rorm does nol become a permit until signed by the BUtLDING
OFFICIAL; that the work will be in accordance with the approved plan in the
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Th. C.ntor of Ih. Lob Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~1(tJe{(( Itkq
I
~-;) -, - (,( (.(.
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(' u ~ to 111
Hrl1 L(~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/';-)/ ;! (_,.J
-I ) L_V' +.1 CLI } 1/11/1 uil__Jr I (- n,.
)
Accepted
/
Accepted With Corrections
Denied
Reviewed By: JdAcr~1l Fwf?f:....IMt4f\/{lJ
Date: 3/30/CJCi
. I
Comments: ...KwoFF r'\1u~r 3~ CftJNIJEy€.b "'0 ANO Al..ON(,. D'U;f1Al~E.. A1JO JT'ILJ~
CAs.Et'fE..rrs As MlJcl--l 19', -awl-rle"'L.. -
tJ~E
CAIJ'TION w,",e:1\l Ct,^J~ Tfl..Uc..nON
AC"II.lI1"'1' oc.c..Jrts JlJERfl.. -rlo/E: CATen /3A.SIN ON "THE: "'cAn. Lor <!on.^,~Q AS
""0 NoT t)AMA(,E' ,-,.
SEE. IAl1="C1r't,N'\A-"nol\J oN i'tEvf:ft.SE. SlOE..
r; AI.... L ~ tlAOt'
~uS, SE Fi....st./
w,'TJot CA""CH BA.5IN llN R€.'AIl.. '.-<iII""
.cOR.JIJ({l.
SEE. A1TAC.HM[AlT5: J. hNAl.... a~.4l)IAl~ INSPEC'Tt:;:)N INrofl..M,q,..,ol\1 2. Artr'\6IAl6. Pt.-A^-!
3. f'(ltl.s~1U CDAlTI1.0L. M fAsua.€' 5
4. t 11.05/0'" (1oAl'TR 01.- ?L.....iU
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION \
SITE ADDRESS l/524 /-.(Cl",^'^"-C,---,Io~~J- ~,
NATURE OF WORK fle<<.d ~~
USE OF BUILDING ~~
PERMIT NO. e>zCZ -2l1 DATE ISSUED s -?a -
CO NTRACTO R f!..o\.:...-*- IV\ c.!) eLl r-VVJ..1----
NOTE: THIS IS NOT A PERMIT FOROANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
nfl/CTO. DATE
: :~~:I:;ION (Prior to Backfill) I ~l'~y,~~ :s~~q::9
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~OUGH - INS
SEWER I WATER I SEPTIC K )) '7/2.,110;
FRAMING V
INSULATION (/;1) 7Sr,/9 5
ELECTRICAL r;T
PLUMBING @ _ 7/ , /9&j I
HEATING (if reCWired). l/ (11) 7/1(1''1
FIREPLACE (L.\.1;?'~~1v~'. (J ftJ~ '7- Ih..- ~9
GAS LINE AIR TEST~;; ~- ~ f; - .;J1-~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
we
/I'+'-
GRADING (Prior to Sodding)
BUILDING T CO 70 ',/ II h&f
ELECTRICAL
PLUMBING
HEATING iYltJl/6-'
DO NOT
/.;r,,]c ~
t< ;../ ~
1/;6 J'1CJ
t'/'16 ))/!2- /6 )
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
~ and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850